Matthew Wiens, PharmD, PhD

PULSE OXIMETRY TO IMPROVE POST-DISCHARGE

SURVIVAL IN UGANDA

Multi-site cohort study: Mbarara, Uganda

Admission n=1307

Discharge n=1242

Post-discharge mortality n=61

AUC = 0.82

Adjusted influence of predictive variables

Wiens et al. BMJ Open. 2015;5:e009449

The math is complex!

Pulse oximetry may be unavailable!

English et al. JMIR Mhealth Uheallth. 2016;4(1):e16

English et al. JMIR Mhealth Uheallth. 2016;4(1):e16

English et al. JMIR Mhealth Uheallth. 2016;4(1):e16

English et al. JMIR Mhealth Uheallth. 2016;4(1):e16

Home Referral and Discharge Kit

• Education for mother• Post-discharge

vulnerability

• Health behavior

• Early recognition

• Early health seeking

• Incentives• New bed net

• ORS

• Soap

Wiens et al. Submitted

Impact

Outcome

Cohort 1

(control)

N=1242

Cohort 2

(intervention)

N=202

OR (95% CI)

Post-discharge

health seeking383 (30%) 177 (90%) 17 (11 – 27)

Re-admission 72 (6%) 22 (11%) 2.0 (1.1 – 3.3)

Death 41 (3.5%) 5 (2.5%) 0.75 (0.29 – 1.92)

Conclusions

1) Post-discharge mortality is a problem

2) High risk children can be identified

• Pulse oximetry is important!

3) Interventions can improve health & save lives

4) Validated & evaluation in larger clinical trials needed